La percepción cinematográfica en la prosa de Azorín: un paseo por París

En el marco del homenaje dedicado a nuestro compañero y amigo Francisco Ramón-Trives hemos elegido este autor por ser alicantino, como él, y esta obra porque en París fue donde cultivó el amor a las letras francesas y allí conoció a Matilde, su Amor

Galaxy clusters with the square kilometer array

We review some science cases for galaxy clusters and the impact that the future SKA data will have in those analyses. We first describe how the search for galaxy clusters through radio-sources will be significantly improved through the detection of much fainter radiosources in a big volume. Secondly, we bring out the benefits of using very sensitive radio data to study the thermal and non-thermal component of clusters and disentangle the main processes happening in the physics of their plasma. Moreover, we discuss the possibility of using the high frequencies of the SKA to separate the thermal Sunyaev-Zeldovich (SZ) effect from the radio halo emission and use the former as a mass proxy for galaxy clusters. Finally, we investigate how the very high sensitivity and spatial resolution of SKA will result into a great improvement in the lensing treatment, underlining the lensing distribution of the 21-cm intensity from the reionization period. As a whole, SKA will become an impressive window covering a significant wider range in redshift to look at an unknown radio universe and set constraints on different mechanisms happening in clusters.This work has been supported by a grant funded by the “Consorzio per la Fisica di Trieste”. SP also acknowledges support by the PRIN-INAF09 project “Towards an Italian Network for Computational Cosmology”, by the PRIN-MIUR09 “Tracing the growth of structures in the Universe”, and by the PD51 INFN grant. Partial support is also provided by Spanish Ministerio de Ciencia e Innovación (AYA2010-21322-C03-02). JD acknowledges support from the Spanish Ministry of Economy and Competitiveness (MINECO) through grants AYA2010-21766-C03-02, AYA2012-30789, and the Consolider-Ingenio project CSD2010-00064 (EPI: Exploring the Physics of Inflation). YA is financially supported by the Spanish Ramón y Cajal programme (RyC-2011-09461) and grant AYA2013-47742-C4-3-P (MINECO), as well as the ‘Study of Emission-Line Galaxies with Integral-Field Spectroscopy’ (SELGIFS) exchange programme, funded by the EU through the IRSES scheme (FP7-PEOPLE-2013-IRSES-612701). BA acknowledges financial support for a postdoctoral fellowship from the Observatory of Paris.Peer reviewe

Non-Melanocytic Benign Skin Tumors in Children

Background: Dermatologists often attend children with benign skin tumors and cysts. The decision to perform dermatologic surgery in children may be difficult to make, especially in cases of benign tumors. Objective: The objective of this study was to determine the nature of non-melanocytic benign skin tumors amenable to dermatologic surgery in children. Methods: Histopathologic studies of skin tumors in children treated by our department between January 2004 and December 2005 were studied. Malignant and melanocytic tumors were excluded. Age, sex, type of tumor, diagnostic category, site, size, reason for removal, type of anesthesia, and any other associated disorders were recorded. Results: The records revealed that 121 patients presented 129 non-melanocytic benign skin tumors (73 in boys and 56 in girls). A total of 27 different anatomopathologic diagnoses were found. The most frequent was pilomatrixoma with 27 cases (20.9%), followed by infundibular cyst with 14 (10.9%), and molluscum contagiosum with 13 (10.1%). Tumors were located on the head and neck (45.7%), trunk (34.1%), and limbs (20.1%). The most frequently affected age group was children aged 11-14 years, which included 50 patients (38.8%). The main type of anesthesia used was local in 54.6% of the cases, sedation plus local anesthesia in 39.7%, and general anesthesia in 5.7%. The reasons that led to removal of the tumors were: increase in the size of the tumor (49%); various types of discomfort, such as severe itching or pain (30%); parental concern (4%); diagnostic uncertainty (16%); and esthetic reasons (1%). Conclusion: There is a wide diversity of non-melanocytic benign skin tumors in children, some of which require surgical treatment. Pilomatrixomas appear to be the most frequent benign tumors; there are also high frequencies of infundibular cysts, pyogenic granulomas, and viral tumors. Most can be removed under local anesthesia, with or without sedatio

Los corticoides epidurales en el tratamiento del síndrome del canal lumbar estrecho

Se presenta una serie de 67 pacientes diagnosticados de síndrome del canal lumbar estrecho, tratados todos ellos con infíltraciones epidurales de corticosteroides, asociadas a un programa de rehabilitación realizado a continuación de las inyecciones. Tras el análisis de los datos se ha observado un porcentaje de buenos resultados cercano al 80%. Asimismo, el estudio ha puesto en evidencia la influencia clara del factor rehabilitación en la calidad del resultado final de los pacientes.The authors present a study on 67 patients with degenerative lumbar spinal stenosis. The treatment consisted in epidural injections with corticosteroids and a program of physical therapy. There was 80% of good results. A clear influence of the physical therapy program on the quality of the final result, has been proved

Health benefits of an adverse events reporting system for chronic pain patients using long-term opioids

Background: Safety data from long-term opioid therapy in the real world has been poorly studied in chronic non-cancer pain (CNCP). The aim was to design a pharmacovigilance data recording system and assess whether participation in this recording system improves pain management, enhancing patient's health status. Methods: A pharmacovigilance data recording system was conducted during 24 months. Data were self-reported by patients (pain, adverse events [AEs] and healthcare resources use) and physicians (morphine equivalent daily dose [MEDD] prescribed and suspected adverse drug reaction [ADRs]). Outcomes from patients with (case) or without (controls) suspected ADRs and cases follow-up were also compared with Spanish Pharmacovigilance System data. Results: A total of 753 patients were recruited in 897 visits. Fentanyl and tramadol were the most prescribed opioids, 89% with concomitant drugs, pregabalin being the one with the most potential drug interactions. Cases presented significantly higher pain intensity (VAS 67 ± 26 vs 59 ± 30 mm, P < 0.05), number of AEs (8 ± 6 vs 5 ± 3 AEs/patient, P < 0.01), polypharmacy related to pain (65% vs 34%, P < 0.01) and MEDD (139 ± 130 vs 106 ± 99 mg/d, P < 0.01) than controls. Furthermore, cases presented significant higher changes in pharmacological pain therapy due to pain, unplanned emergency visits and hospital admission than controls. Physicians notified 168 suspected ADRs mostly related to neurological or psychiatric events and 8% of them were previously unknown. Conclusions: This data recording system provided important information to achieve a better control of CNCP pharmacological pain therapy, improving patient's health status and reducing costs to the Health System

OPRM1 influence on and effectiveness of an individualized treatment plan for prescription opioid use disorder patients

Screening for opioid use disorder should be considered in chronic non-cancer pain (CNCP) patients with long-term use of opioids. The aim of our study was to assess the effectiveness of an individualized treatment plan (ITP) for prescription opioid dependence that included screening of pharmacogenetic markers. An observational prospective study was performed using prescription opioid-dependent CNCP outpatients (n = 88). Patients were divided into nonresponders, responders, or high responders according to their response to the ITP. Genotyping of OPRM1 (A118G), OPRD1 (T921C), COMT (G472A), ABCB1 (C3435T), and ARRB2 (C8622T) was performed by real-time PCR. Our ITP achieved a significant reduction of the morphine equivalent daily dose (MEDD) in 64% of responders, including 33% of high responders. Nonopioid medication or buprenorphine use was significantly higher at final versus basal visit. 118-AA OPRM1 patients required significantly lower MEDD at basal and final visits. Our ITP showed effectiveness and security in reducing MEDD in opioid-dependent patients, with good conversion to buprenorphine that was more pronounced in 118-AA OPRM1 patients

Gender based differences, pharmacogenetics and adverse events in chronic pain management

Safety data in chronic non-cancer pain (CNCP) with long-term opioid therapy has been poorly studied and can be differently influenced by gender. Furthermore, pharmacogenetics (PGx) could possibly be used to tailor pain medication based on the individual's genetic background. The aim was to assess whether PGx applied to a pharmacovigilance system could help to improve a patient's security profile. A pharmacovigilance data recording system was conducted over 24 months, including genotyping of OPRM1 variants (opioid receptor, A118G) and COMT (enzyme that degrades catecholamines such as norepinephrine, G1947A). Pain intensity (visual analogue scale, VAS), morphine equivalent daily dose (MEDD), adverse events (AEs) and suspected adverse drug reactions (ADRs) were recorded and analysed by gender. The Ethics Committee approved the study and data were analysed with R 3.6.0 software. A total of 748 patients were recruited in the study (67% female, VAS 62 ± 29 mm, MEDD 119 ± 114 mg/day) reporting a median of 6 (3.5-9) AEs/patient. Women presented more nausea, headaches, insomnia, loss of appetite, weight change, depression and dizziness than men. Analysis by genotype demonstrated that PGx influenced the prevalence of vomiting and depression in men, dizziness in women and sexual dysfunction in both. Physicians notified 150 ADRs mostly in females (79%) related to nervous system disorders. PGx applied to a pharmacovigilance recording system provides important information to achieve a better knowledge about AEs in CNCP pharmacological therapy. OPRM1 and COMT polymorphisms were associated with AEs in CNCP patients that differed according to gender

Design and validation of an instrument for the detection of school difficulties in Primary Education

En la actualidad se sigue encontrando un porcentaje bastante elevado de aprendices con dificultades de aprendizaje que limitan su progreso académico. Se sabe como consecuencia de las investigaciones efectuadas en los últimos años que estas complicaciones no aparecen de manera espontánea en un momento determinado, sino que tienen su origen en los primeros niveles educativos y que tienden a incrementarse a medida que se avanza a lo largo de la escolaridad. Una explicación de este hecho se debe a que no siempre las carencias escolares se detectan a tiempo, lo que impide la toma de medidas que den respuesta a tales necesidades. Investigaciones recientes han evidenciado que la intervención educativa más eficaz es aquella que comienza en los primeros cursos, sin embargo, no se dispone de muchos recursos destinados a los docentes que les facilite la identificación temprana de los problemas de aprendizaje. Con la finalidad de dar respuesta a esta necesidad se elaboró el presente trabajo que tiene como objetivo favorecer la detección de las dificultades de aprendizaje en los primeros niveles de la escolaridad formal mediante la elaboración y validación de un instrumento que permita la puesta en práctica de medidas de detección e intervención educativa. Los resultados obtenidos evidencian que la herramienta diseñada constituye un recurso educativo de gran eficacia que ofrece a los docentes información relevante acerca del dominio de las habilidades, conocimientos y competencias que poseen los estudiantes, lo que brinda la posibilidad de adecuar el proceso de enseñanza a las características de aprendizaje de los escolares.At present, despite the numerous works that have been carried out on the learning problems that students encounter throughout their training, a fairly high percentage of apprentices with learning difficulties that limit their academic progress continue to be found. It is known as a consequence of the investigations carried out in recent years that these complications do not appear spontaneously at a certain moment, but rather have their origin in the first educational levels and that they tend to increase as progress is made throughout the education. scholarship. One explanation for this fact is due to the fact that school deficiencies are not always detected on time, which prevents the taking of measures that respond to such needs. Recent research has shown that the most effective educational intervention is the one that begins in the first grades; however, there are not many resources available for teachers to facilitate early identification of learning problems. In order to respond to this need, the present work was developed, which aims to favor the detection of learning difficulties in the first levels of formal schooling through the development and validation of an instrument that allows the implementation of measures detection and educational intervention. The results obtained show that the designed tool constitutes a highly effective educational resource that offers teachers relevant information about the mastery of skills, knowledge and competencies that students possess, which offers the possibility of adapting the teaching process to the needs of the students

Los corticoides epidurales en el tratamiento de la hernia discal

Se presenta una serie de 233 pacientes diagnosticados de hernia discal lumbar y tratados mediante infiltraciones epidurales de corticoides, asociadas a un programa de rehabilitación realizado a continuación de las inyecciones. Los resultados con dicho tratamiento fueron satisfactorios en un 75% de los casos. Se observó una mejor evolución en pacientes varones, en pacientes cuya profesión conlleva esfuerzo físico, en hernias discales L5-S1, y en aquellos que han seguido un programa de rehabilitación tras las infiltraciones.An study on 233 patients with lumbar disc herniation, treated by means of epidural injections of steroids, added to a physical therapy programme is presented. The results obtained were fully satisfactory in 75% of the cases. Better results were observed in male patients, in patients subject to heavy physical activity in their laboral life, in disc herniations at L5-S1 level, and finally in those patients following a physical therapy programme after injections

Oxycodone/naloxone versus tapentadol in real‑world chronic non‑cancer pain management: an observational and pharmacogenetic study

Tapentadol (TAP) and oxycodone/naloxone (OXN) potentially offer an improved opioid tolerability. However, real-world studies in chronic non-cancer pain (CNCP) remain scarce. Our aim was to compare effectiveness and security in daily pain practice, together with the influence of pharmacogenetic markers. An observational study was developed with ambulatory test cases under TAP (n = 194) or OXN (n = 175) prescription with controls (prescribed with other opioids (control), n = 216) CNCP patients. Pain intensity and relief, quality of life, morphine equivalent daily doses (MEDD), concomitant analgesic drugs, adverse events (AEs), hospital frequentation and genetic variants of OPRM1 (rs1799971, A118G) and COMT (rs4680, G472A) genes, were analysed. Test CNCP cases evidenced a significantly higher pain relief predictable due to pain intensity and quality of life (R2 = 0.3), in front of controls. Here, OXN achieved the greatest pain relief under a 28% higher MEDD, 8-13% higher use of pregabalin and duloxetine, and 23% more prescription change due to pain, compared to TAP. Whilst, TAP yielded a better tolerability due the lower number of 4 [0-6] AEs/patient, in front of OXN. Furthermore, OXN COMT-AA homozygotes evidenced higher rates of erythema and vomiting, especially in females. CNCP real-world patients achieved higher pain relief than other traditional opioids with a better tolerability for TAP. Further research is necessary to clarify the potential influence of COMT and sex on OXN side-effects